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031-255-010
yid o 031-255-010 PERMIT#96-0294 YANG, Her Pao 935 Colusa Ave., Oroville Cont; Skilled Bldrs Add Bathroom/SF 031-255-010 05-1296 YANG. HERPAO 935 COLUSA AVE, OROVILLE Cont: COMM ACTION AGENCY REP EX WTR HTR 5 5 `J NOTES RESIDENTIAL PERMIT N0. — 031-255-010 — - -05-1296 YANG, HERPAO 935 COLUSA AVE, OROVILLE Cont: COMM ACTION AGENCY REP EX WTR HTR SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER iw azo ft JOB FINALED (Dateor / v Signature J=OK 0 .Not OK = NotRealicable =Not Ready MOBILE HOMES . Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer, Location -Test -Fall -C/O -Concrete 4. Water, Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or/ /" L 'ftJ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBfLE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water, MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert 10. Exits; Insp.-Sketch 11. Cert of Occupancy MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric B. Fnng.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Root, Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GR 5. Elec.; Pool Lighting; 15 Vofts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit ' 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water, MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric B. Fnng.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Root, Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GR 5. Elec.; Pool Lighting; 15 Vofts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main Conduit ' 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 =Not OK = NotAppricable Rea4 =Not Ready RESIDENTIAL, (Single & Duplex) . Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Gmd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Gmd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a Hold Downs and Special Anchors 7. Slab, Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; FalkFitting-Test-2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Datp I PLUMBING rmit) Oxcept #'s 17. W Access -Comb on Air Baffle 18. Wa Pi e• Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub_kShower, Second Floor -Tub Access 22. Ga ipe; Sixe & Anchors 23. Fire Sprinkler, Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Meth Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or AI 31. Range Circle/ /ga Cu or Al -Oven Circ. / /ga Cu or AI Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels -Motors -Meth. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Fumace-Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting_ Rtng. 49. Fireplace Ties or Type AFlue-Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Botts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Watts -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Cana B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Au -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door, Swing -Landing -Closure C. Garage -Damper Wtr. tr.; Ve -CI ce-C r Connector-P.R.V. in Garage; Above Ficor-Meth. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor O Yes 83. Following InslldAkin O Yes O No/Walks O Yes O NwPlanters O Yes O No 84. Stucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F1. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: IJU I It C;UUIV I Y FtKIVII I iNU. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR. INSPECTION #: (530) 638-7636 (OROVILLE) (530) 891-2834 (CHICO) BP051296 OFFICE #: (630) 538-7541 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Issued Date: 05/16/2005 APN: 031-255-010-000 effect. / 7 License Class License Number: : // !/� / Date: 16 Contractor: CAq'7 �6�.[�� Site Address: 935`COLUSA AVE ORO Map Index: OWNER -BUILDER DECLARATION I hereby affirm -under penally of perjury that I am exempt from the Description: REPLACE EX WATER HEATER p Contractors' Slate License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant (or such permit to file a Owner: YANG HER PAO & YING YANG signed statement that he or she Is licensed pursuant'lo the provisions of 935 COLUSA AVE the Contractor's State License Law (Chapter 9, commencing with Section OROVILLE, CA 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 95965 violation of Section 7031.5 by any applicant, for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an Applicant: COMMUNITY ACTION AGENCY OF BUTTE pp owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, COUNTY INC. provided that such Improvements are not Intended or offered for sale. If however, the building or Improvements are sold within one year of completion, the owner -builder will, have the burden of 2640 SOUTH 5TH AVENUE proving that he or she did not build or Improve for the purpose of OROVILLE, CA 95965 sale.). (530)538-7559 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Slate License Law does not apply to an owner of properly who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Stale License Law.). Contractor: COMMUNITY ACTION AGENCY OF BUTTE COUNTY INC. ❑ I am Exempt under Article 3 of the Business and Professions Code Date: owner: 2640 SOUTH 5TH AVENUE OROVILLE, CA 95965 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: (530)538-7559 ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the License #: 617201 Labor Code, for the performance of the work for which this permit Is Issued. I have and will maintain workers' compensation Insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit Is issued. My workers' compensation insurance carrier and policy number are: Engineer: Policy ❑ I certify that in the performance of the work for which this permit Is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, Census Code: and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: Applicant: C,.r WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor fees. code, Interest, and attorney's CONSTRUCTION LENDING AGENCY This permit Is h reby saved under the applicable provisions of the Butte/ ounty C ��ndlor I hereby affirm that there is a construction lending agency for the Resolutions to, k indic it d above for WIfIch fees have been pa performancof the work for which this permit Is Issued (Sec 3097 Civ.) _ - - Dale* By: Name: I PERMIT EXPIRES O ' Address: Date ❑ 1 hereby certify Thal the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safely Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. this application, that the above information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with I hereby I hereby certify that I have read all county and slate laws relating to building construction. I acknowledge It Is unlawful to alter the substance of any official form or document of Butte County. authorize representativess/ of Butte County too enter upon the above mentioned property for Inspection purposes. O/+h _`'S'Qn Signature: Print Name: Date: El Owner ❑ Contractor ❑ Agent for Owner Agent for Contractor B. C. Building Permit 01-16-04 pp 1 IJU I It C:UUN I r FLKIVII I NU. DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR -INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) BP051296 OFFICE #: (530) 538-7541 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and Issued Date: 05/16/2005 APN: 031-255-010-000 effect. /7 License Class : _ License Number: 617 M ' p Date: /6 Contractor. �".�i9a� i" -G-1.4- Site Address: 935-COLUSA AVE ORO Map Index: OWNER -BUILDER DECLARATION I hereby affirm. -under penalty of perjury that I am exempt from the Description: REPLACE EX WATER HEATER p Contractors' Slate License Law for, the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demollsh, or repair any structure, prior to its issuance, also requires the applicant .for such permit to file a Owner: YANG HER PAO & YING YANG signed statement that he or she Is licensed pursuant`lo the provisions of 935 COLUSA AVE the Contractor's Slate License Law (Chapter 9 commencing with Section OROVILLE CA 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any 95965 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Stale License Law does not apply to an Applicant: COMMUNITY ACTION AGENCY OF BUTTE pp owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, COUNTY INC. provided that such Improvements are not Intended or offered for sale. If however, the building or improvements are sold within one year of completion, the owner -builder will' have the burden of 2640 SOUTH 5TH AVENUE proving that he or she did not build or Improve for the purpose of OROVILLE, CA 95965 sale.). (530)538-7559 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' Stale License Law.). Contractor: COMMUNITY ACTION AGENCY OF BUTTE COUNTY INC' ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: owner. 2640 SOUTH 5TH AVENUE OROVILLE, CA 95965 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: (530)538-7559 ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit License #: 617201 Is Issued. J9 I have and will maintain workers' compensation Insurance, as required by Section 3700 the Labor Code, for the performance of Architect: the work for which this permit is issued. My workers' compensation Insurance carrierand policy number are: Engineer: j l_ /A/50, Carrier:/ (CLQ _ Policy ❑ 1 certify that In the performance of the work for which this permit is Total Square Ft: 0 S. F. issued, I shall not employ any person in any manner so as to Valuation: $0.00 become subject to the workers' compensation laws of California, Census Code: and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: .0d /,y.0�'fy���� Applicant:.c WARNING; Failure to' secure workers' compensation coverage is unlawful, and shall subject an employer.lo criminal penalties and one / hundred thousand dollars (8100,000), in addition to the cost of damages as provided for in Section 3706 of the Labor compensation, code, Interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit Is h reby sued under the applicable provisions of the Butte ounty C e and/or Indicat d above for fees have been pa I hereby affirm that there Is a construction lending agency for the Resolutions t vyFAch performance of the work for which this permit is Issued (Sec 3097 Civ.) By = Date• Name: PERMIT EXPIRES 0 Address: Date ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification In accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above Information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with I hereby all county and state laws relating to building construction. I acknowledge It is unlawful to alter the substance of any official form or document of Butte County. authorize representativessof Butte County too enter upon the above mentioned property for inspection purposes: Sa Signature: Print Name: �:! tA Sl Date: ❑ Owner ❑ Contractor ❑ Agent for Owner I* Agent for Contractor B. C. Building Permit 01.16-04 pp 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY* OWNER Last Name ~ irst Name Addre 63,r- ! `N 3 c� AV-f— City L?rc✓' State o. Zip Phone S.1c/_ 3 [I/ Fax E-mail CONTRACTOR APICHITECTIENGINEER Name C14.4 Q d&X Co. h Address Zip City �ja✓)/ . State Zipq�3_763-' Phone,, --S ?, 3 Fax 6-3J:- %-:�-/, E-mail Lic. #,6 / 72. , Class e Name Address APICHITECTIENGINEER City Address State Zip Phone Phone 5-1 25- 3 Fax E-mail LENDING AGENCY State License Number APPLICAN NAME Name C' A Wf 7—' Address City �� ✓j State Zip Phone 5-1 25- 3 Fax 3_3 E-mail A PLICANT SIGNATURE X For office us onl : AP# 031 - ms-s'.-o/v Zoning 14Flood Zone WORKER'S COMPENSATION SRA Yes No Occ. j I LENDING AGENCY Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldaAoplSubRgmts.doc PERMIT NO. 5> >�a �0 BIN # LOCATION AP# 031 - ms-s'.-o/v Property Address Cross Street WORKER'S COMPENSATION Policy Number ki, L7 Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Descript'on or Scop of Work- /-L"a- r Gti-z' Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): Page 1 of 2 EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Receiv by: Amount: �� Bldg SRA Rec#: Sheriff �-3eipt 6 �)i SMIP Other t Da(4 16S Total REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND /N INK ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non-heated and A/C for Non-Residential Buildings. i ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (b) Tie dow, n or fnd ,plans, all in duplicate. ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet-signed by the engineer. - ❑ 8. Flood Elevation Certificate, wet-stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items maybe required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance''and site plan approval from .the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the'Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please. contact a Permit Assistant at (530)538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 JOB FINALED (Date) r — Signature J=OK O = Not OK = Not Applicable = Not Ready Date UNDERFLOOR (Plans) OK except ft's RESIDENTIAL (Single & Duplex) Date FR NG (Continued) " -- 4 an - ost Caps -Anchors -Connectors _ Ing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 311'111911 Ll%ZonjF6-Setbacks-Easements-Flood-Slope tg., Main;'Soils-Elec. G##x&-//'T-Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel -Bloc kouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel ,eD.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric, Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except n's - - 16. W ter Htr.: Vent -Access -Combustion Air -Baffle ------------------------------ 4Wat r Pipe; Test & Anchor -Nail Protection ---------------------------- 1 W.V Test -Fittings & Anchor -Nail Protection -- — ------ —19. Shower Pan; Test First Floor -Tub Access --------------- - -- - - 20. Test Tub & Shower. Second Floor -Tub Access 21. Gas Pipe Size & Anchors ----------------------------------------------------------------------------- Date Card B-1 Date Card -B-1 ---------------- --- ____________Date -- - -------------- Date --- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except ft's ,-pyofixture & Transformer Clearance_Ins Protection ----------y---- ---------------- ---------------- _Receptacles Spacing -Lights & Switches at Doors Size' oxes-&-No of Conductors _Stap led - - om x Installed Close to Edge of Studs & C J ---- - -...--------------- - - -- - -..-------- quip. Ground made up w/Meth. Fasiners-Bond Gas & Water ----- ---------------------------- 2 Appliance Circuts in Kitchen &Conductor Size GFl --------------------------------------------- -. -- 28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size ga. Cu or At 29. Range Circ ga. Cu or AI -Oven Circ. ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No _--------._- ervice-Riser Conductors & Ground -Main Disconnect -- ---------- quip. Clearances Panels -Motors -Meth. Equip --- - -- -------------------- ----------------- - --- -- 42- ofhes Closet Light -Shower Light -Spa Light ---------- ---------------- - ---- - ----- ----- 33. Smoke Detector --- ---------------..... -- ----------._.. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL(Permit) OK except P's 34 A.C. Ducts Insulation & Support --- --- - --- - - - -- - 35. -Vent -Fan: -Exhaust above insulation 36 Condensate Drain & Overflow Size & Grade 37. Furnance Vent: Access -Comb Air Return Air Vent -115 outlet 38 Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAM (Plans) OK except u's -51SSI per Material & Anchors 4 Wall tads -Nailing. Spacing & Bracing- Plates -Sound I, -g Walls over Girders & Floor Nailing 4 Dra,f.t-Stop in Walls (rat proof) 4 re Sops: FiFurred Ceilings -Stairs Chases -Tub --- ------ - ......... _..... .. 44 eaders & Beam -Size & Bearing -ype A Flue -Fireplace Throat clearance ttic ess; Size & Romex Protection -Draft Stop -Ins. Baffles ------------- --- -- 4,-,-9-drT-3bAndows or Exiting Doors -Sill Hgt. & Dimensions --------------- -- n Framing ---_ - -ro erty LineFire.all & Openings Ext. Doors -One 3=Check Garage -3rd Story, 2 Exits ------- -- - ai ; Idth-Headroom-Rise-Run-Landing-Fire Protection plywo n Roof Overhang -Attic Vents -Rafter Outriggers -------------------- - iding-Nailing Veneer ----------------------------------- — rip Screed -Fd. Vents-Underflr. Access ------ - ---- -- lazing Area Glass Protection -Skylights -Plastic ea ails: Nailing -Bolts nsulation-Walls-Ceilings ------------ 60. Infiltration -Walls -Windows Date Card B 1 Date Card B-1 /_--r Date Card B-1 Date Card B-1 Date FINAL (PI ns) OK except a's 6A -,-x' ps-Door & Sidelight Protection -Landings _ - - - Smo elector----- — urnace eats -Clearance -Comb. Air -Connector - 1 rage: Above Floor -Ducts -Meth. Protection ------------ -- - - ---- Be m Exiting --- -- G.F &"Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel Breaker Sizes & Labels ------ -------- -- -- ---------------------- rs & Rails ----- ce or Stove: Clearances -Hearth - ------------- --- ---- Elec. Outlets at Wood Panel: Int. & Ext. 7l�. &"Appliance; Grnd -Air Gap -Cooking Clearance = _ s --------- ----- tr-2nga Outlets & Receptacles at Kit. Counter 32,-{aree�Fire Door. Swing -Landing -Closer ----- - - --- - uct in Garage Damper - - - - - - --- --------------------- 7 t .-Vents-Clearance-Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meeh. Protection ----- ------ - ------- - --- Ib.. Elec. - & - Mech -Eq uipListed for Location --- --- eceptacles in Garage: (G.F.I.)-Romex Protection Insulation -Foam -Looked in Attic 0 Yes . uard -Rits & Deck Construction -Post Caps Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Flo El- - ------ ----- i- yn_er ---- ---------- - 80. Following ins Drive Yes ❑ No: Walks es ❑ No. Planters ff Yes ❑ No - --- ---- --- -- ------------------------ ------------------ n -Finish - --------------------------------- nit: Disconnect. nect. Electrical, Plumbing . ... 2/�------------------ --------- Vents Above Roof: Plbg -Appliance-Fireplace.-Clearance to Open ns _ _ Well. Disconnect, Electrical Plumbing . Exterior tet Trim G.F.I. Receptacle Underground enUl -- Throughout. -House ----, --------------------- ---- ----- --- —-_ lass ection 8" orrections from Previous Inspections � - ----- ----------- Ga/s Test -Meters Tagged: Gas -Electric 9CYWa ewer Connected-C'O to Grade -HD Approval ---- ---- --- --- . Energy Compliance Certificate -Other Certificates --------------------------- Date� 6 Car � Date Card B-1 Date ,� /! Ca�-��,,,!TYY;���,��'' Date Card B-1 - Date Card B-1 Date -- Card B-1 Comments at Final: V=OK 0 = Not OK '=Nott ReadApply MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements - Setbacks - Easements 2. Footings; Soils-Size-DepthSpacing-Connectors-Steel 2. Soils; Special MH Support Sketch 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 3. Sewer, Location -Test -Fall -Q Concrete 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg: Bracing 4. Water, Location -Test -Easement Needed (Sketch) 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 5. Electricity; Location-Clearances-Gmd-/ /Amp -Concrete 6. Carports; Windows -Doors 6. Gas; Location-TestVNrap; / 112ft. / /Nat. or/ / L"ft./ /LPG 7. Electric 7. Well Clearance & Disconnect 8. Frmg.; Sils-Anchors-Studs-Rftrs-Trusses 8. Utility Clearance 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Root,, Shthg-Roofing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements- Setbacks Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line POOLS (Plans) OK except #'a 3. Gas; MH Test -Demand Vake-Connector 1. Setbacks -Easements 4. Electricity; MH Test-Crossokers-Breakers-Clearances 2. Soils; Compaction -Structure Stability 5. Drain; MH Test -Fall -Flex Connector 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 6. Water; MH Test -Regulator -Connector 4. Elec.; Receptacles and Lighting, Distance-GFI 7. Water and Sewer Connected -C/0 to Grade -HD Approval 5. Elec.; Pool Lighting; 15 Volts-GFI 8. Gas and Electricity Tagged 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 9. Tie Downs -Type -Installation Cert. 7. Elec.; Bonding; Metal w/6 -Circulating Equip :Heater 10. Exits; Insp.-Sketch 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 11. Cert of Occupancy 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plana) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils-Size-DepthSpacing-Connectors-Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Rfg: Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Root,, Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'a 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/6 -Circulating Equip :Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION - 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT 96- 05z-/ ASSESSOR PARCEL NUMBER 031-255-010 ZONING AR A BUILDING PERMIT OWNER HU PAO YANG TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS 935 COLUSA AVE OROVILLE CONTRACTOR'S NAME SIZILLED BLDR TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 33.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 23.00 Energy Plan Checking Fee $ 23.00 . ARCHITECT OR ENGINEERS MAJUNG ADDRESS Penalty $ BUILDING ADDRESS 935 COLUSA PERMITFEE $ 99.00 OROVILLE PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 14.00 LOT NO. SUBDNISIOWS NAME PARCEL MAP Solar or heat pump water heater 23.00 Water piping 15.00 USEOFSTRUCTURE SF 6 Duplex ❑ Mobilehome ❑ Other SPECIFY Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New ❑ Addition ❑X Remodel ❑ Ublities ❑ Installation ❑ Other ❑ Describe Work: ADD BATHROOM Mobile Home I S I G W 1 @20.00 PERMITFEE $ 34,00 Contractor ELECTRICAL PERMIT Filinq Fee 20.00 Main ServiceEOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in II force and effect. n License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ( 8 ACC. BLDS. ) SO. • 85 3.5t FT. LJ CNS. NEW CONST. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER SINGLE APPARATOUTLET S US ) 8 Ex. Occup. (OUTLET OR FO(TURES ) L @ I.50_ BA20 .SO Ex. Occup. ( DUTLEEDTs PLNS. OR ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 20.85 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 9 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) (—I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall with comply with se ovisions. ___ Date Si re of Applicant - ❑ Owner f�Contractor ❑ Age AiPOSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 46.00 GCC CONST. TYPE JTOTAL FEE $ 199.85 HAZ. I D. FE IMP I FLOOD CDF PARCEL I PD HID ISSU This permit is hereby issued under the of the Butte C my Code and/or indicated ab for whic s have By PERMITEXPIRESO p�� ©?(O'er applicable provisions Resolutions to do work been aid. p //Date�y�J co (Data) Receipt No. 191061 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT ,.COUNTYOF.BUTTE -DEPARTMENTOFD ELOPMENTSERVICES-BUILDINGDIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET C� �I OWNER P o0 Proposed Building U Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1, All items have been submitted . ........................................ . 2. Plot plans, 3/4 sets, signed by preparer of plans . ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ................. 6 .......................... 6. Energy Design Compliance and supporting documentation . ................. . 7. Statement of Intent for Non -Heated and A/C Buildings . ..................... . 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehorne"data and manufacturer's installation instructions, 2 sets. ........... ..Fees of $ . ........... f ..... 1 Impactfees as shown on attached schedule. . . California Department of Forestry plan approval/fees........................ 13. Flood elevation letterc(1100 year flood) by California Engineer. .. ............ . 14. ,.Sanitation and plot plan. approval :SP_i 0eY- Health Department . ............ 15. City of Chico plumbing permit..... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development.about (A) Improvements (B) Drainage. .......... . 1 19. Driveway permit (construction approval required prior to occupancy). . . 20. Pre -inspection for required. .. a Building � (Date) ) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _ ) ............ 24. Recorded copy of Agricultural Acknowledgement Statement . ................... 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27. Letter of intent on building use . ......................................... 28. Mobilehome utility clearance . .......................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . .............. . 31. Existing violations/expired permits . ...................................... 32. Plan check list . .................................................... . 33. 34. W you issue the ermit, pro�c�ess �s follows: Ma�i Q�owner. Mail to contractor. "V1 l Telephone Viand hold for pickup at C� office. Deliver with inspector. Other i' Parcel Creation / Acreage Applicant lam- Date t Copy of Haz-Mat form sent' Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By i, The following data must be submitted prior to permit issuance: (Circle new item, not checked above). 1. Index permit for above items No. A 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved byt s /Q63 is _VS Date Sets of plans on hold in File cabinet 3 AP folder Copy - Department of Public Works BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Per Building) School District Building Department No. A.P. Number I(C)Jurisdiction: City �� County Property Owner Property Locatic Subdivison Lot No. Residential Development �� Sq. Footage No. of Living MHI Addition (Group R) Units -� Commercial/Industrial 0 m Sq. Footage (Including Exterior Roofed Areas) Date (Floor Plans reviewed by School District Personnel) District Identification No. 9 6 0 0 9 �. ® b�School District certifies that yi5 (Street Address) (C P60— "A4 �. (Ap icant) "p (Zip has complied with the requirements of Resolution No. �� �b by payment of $ representing square feet. As 2926 $ FULL MITIGATION $ hool j0isgxAikprntative Date Paid by Check # Bank Number Paid by Cash Remarks: r) ,�Ve 4 If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school'diistrict) feeform.wkl (11/94)dmm ,�yy,, ,�yi.{ •ti 'S wrt 6'YYp''t •'"" y !','."C'�i •J �a� I'rx t 'w s��.-n ti :.1 ,.'t caw Ia;f. �;'�•i�•�„� t 1+t�Z�: •� 1... ���ykfl4?ii 1•,w� y. � y ,•h. Y ped,+ I idwroCL� �' S.G J.3� i,a 7'' .t l:l(, i -(�y� ,y Mri t I e. ,i`R .+u..7r!d 1K+�;�L}a��.'.tw� Y V'1 P/,}J.7,"+�C0.- V7 itY5� i� fi i'$�t i� �Y('49•. {!{^ w } its +:p F� 1a �1' /5l't •p`I-YM1�7ft'h Y.� P��i{T}�i.y,�ri.R.�Y ,, ..11 ��`. 4;i l.fr �{R{I�t �1�{.4 moi,• "l Certificate�of`Compliance Residentlai "« ge 4 , ..: > > . �. ; (Page:;�fofz) '';YA_`."6ATH Row ...AU D I -ri:dzN.., sf Project Tltle °, CISS'-couwSA MCI' t_E : Date Project Address Building Permit # ... M A Yz" (2 U N �,J E 894 — S 4 6 Pian knack /Date Documentation Author .n.:._. Telephone ? A"_Ar= E FO )e A Q I TI O N S e- 100 S F. Field Check/ Date Compliance Method (Package, Point System or Computer) Climate Zone Enforcement Agency Use Only GENERAL INFORMATION" Total Conditioned Floor Area: • W Building'Type:• u --Single Family -Addition Existing -Plus -Addition (check one or more) Mufti -Family Existing -Plus -Addition Front Orientation: North / East Xest / All Orientations (input orientation In degrees and circle one. Number of Dwelling Units:_ Floor Construction Type: <la Raised Floor (circle one or both) - BUILDING SHELL INSULATION Construction Component Insulation Assembly Location/Comments Type R -Value U -Value (attic, to garage, typical, etc.) Wall. * ............ P k C -AL. Wall .............. Roof ............. 3 c�> 'Ta A%_M L 1 Roof ............. J Floor ............. p Floor ............. Slab Edge .... VIA FENESTRATION Shading Devices J Fenestration Orientation Front..... (! ) Fro nt..... ( ) Left....... ( ) Left....... ( ) Rear..... ( ) Rear..... ( ) Right..... ( ) Right... ( ) Skylight ....... Skylight ....... Area Fenestration sf U -Value Interior Exterior Overhang Framing (roller blind, etc.) (shadescreen, etc.) (yes/no) (metal/woc sTA . DPAP e ed V10 M STA c.. THERMAL MASS Type/Covering,.;_. ' ... Area (slab/exposed, tile, etc.) (sf) (inches) Location/Description (kitchen, bath, etc.) Revised December 1992 i<_.,��.......i.,_. ...zu ;:., n. y,..a,,.,ii ._..�a,.r �a ,,�,�aw�.r...st:...�.,�......�.';,ix._.,. •.�,... {,.:'t,�'4. ;:.�u..i r �,.r+Mal abYi r liZ4 act k.... k ,at",• q<+14 .,.x A� :.,. ro yr �.a�, :-drryy r.tt �v:a , .a ak i•ws;; y ��{'i., J. i r xna) dot x a u & !,W d# ai".i, _ 7/.Iw,� i7t'"�� 5 t..:l .Y��fif{`}`i`3♦<,.'J- ���, d'3`.,'�14 J�.s��' t'�N�W'.:,� r�. ..f,y r 3 �, 1N � f yNM �'4. f f - y Kik �� � �, •. _.t f':L...A fit', � '� S41,wa. a d4..i 'u � dt;'�tur �+ti-�:.:.�we � bs.•.. ,' fi.. -.+. _ }¢. Certificate "of,CompIiance: inti ,ResIdeal °� _ W (Page'2,of CF4 R .. _ WATER HEATING SYSTEMS M �!e-�f UNN E 4tx Energy' External Project Title - Rated' Tank Factor or "` ` ODbte HVAC SYSTEMS .. Number Input (kW Capacity _ Standby'.-. Insulation Note: Input hydronic or combined hydronic data under Water Heating Systems, except Design, Heating Load.. ; 2 'Distribution Loss (%)- R -Value " Heating Equipment :Minimum Type and Duct or . .. Heat Pump Type (furnace, heat `Efficiency Location Piping Thermostat °Configuration pump, etc.) (AFUE/HSPF) (ducts/attic, etc.) R -Value Type "(split or package) Cooling Equipment °Minimum Duct Type (air conditioner,' 77 Efficiency`"' "Location Duct 'Thermostat -Configuration heat DumD. evaD. coolinal (SEER) (attic. etc.) R -Value TYDe (split or package) WATER HEATING SYSTEMS 1 1. For small gas storage (rated input:5 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor. J For large gas storage water heaters (rated input 2 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For Instantaneous gas water heaters, list Rated Input and Recovery Efficiency. SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) ?Ae-K-•4.6 6 `oWQ Ab D t770N-s COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6, of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. Designer "Wrier (pe Busl ess & Professions Code) Name: K-44CA Title/Firm: Address: b a a 6 Telephone: Lic. #: �at6dS% (signature) -- (date) Enforcement Agency Name: Title: Agency: Telephone: Documentation Author Name: M �!e-�f UNN E 4tx Energy' External Address: Rated' Tank Factor or Tank Water Heater Distribution Number Input (kW Capacity Recovery Standby'.-. Insulation Type Type in System or Btu/hr)- (gallons) Efficiency Loss (%)- R -Value DEPNIEN A 1 1. For small gas storage (rated input:5 75,000 Btu/hr), electric resistance and heat pump water heaters, list Energy Factor. J For large gas storage water heaters (rated input 2 75,000 Btu/hr), list Rated Input, Recovery Efficiency and Standby Loss. For Instantaneous gas water heaters, list Rated Input and Recovery Efficiency. SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) ?Ae-K-•4.6 6 `oWQ Ab D t770N-s COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Parts 1 and 6, of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/Remarks section. Designer "Wrier (pe Busl ess & Professions Code) Name: K-44CA Title/Firm: Address: b a a 6 Telephone: Lic. #: �at6dS% (signature) -- (date) Enforcement Agency Name: Title: Agency: Telephone: Documentation Author Name: M �!e-�f UNN E 4tx Title/Firm: ' Address: Al tz0V U! D CH146 CA, t ., z Telephone: (o (signature) - - ... .,._ . _ . (date) � ice:, ;� .• �', z w � DEPNIEN A E® (signature/stamp) _. --- (date) Revised December 1992 ,u - �..A.fl-]+V p• ,y,., .,,ynf y. �GixS �f,.�n .T+ !t 'Ai,;' o, ,,. ,� a ux,, - 1r h'i uc .• „h ' ' p 4 ., • 4 IAi-4 15 aJ�.;.�cht.�+i r �p•>#1i}vvPta.tiyyiyi;;±a`�v}c�h�ja:t•:w d,+�.. qk„ ,,• ;l i.,�„ „ .;..,�,� 4*.,3w,,,e 41'.m.liiiw.l��lx4LLgM� �,..L,.�i .t L iy 4 Y.�i Q M1 .{r. ♦l WtY..il 'jr� ..y .. y _... J.... -. , i -,� 11t-tiMTi�•;�,1! J,kt .l71{"y�5 ,r�.. �'}�.�'}„��,,.'ri- T __ •�� yr!^ ... _ i, � � ; .. FM1� � ! _ ' .. ... •. rte d •,r.,i C. r, :•�rh!-!.d _.._ .-c: c.:4.: FJt �•::-:a ... ._,=. - .. 72 COMPLIANCE�ANAI:Y IM---: ;YSIS .,, the .. « existing structure, except when calculating the ;A ANDDITION ALONE { +the '•' water heating' energy 'Nor' any addition in which 4'i it Y?v Any addition =- that is; the sum of all new total number of waterteaters in the building conditioned spaces and associated new exterior increases. The analysis may be performed using walls cellings; and floors within the building— either a special prescriptive package according to " may be shown to meet the energy budget as a the size of the addition orwlth the point system or separate entity. This procedure does not involve any approved computer performance method. �, . • Table PrescriptCompliance of Additions Summary of Section 152(a)1 Requirements of the Standards "' '. .•-, .._..-.,-.«.- .... ,. _ .. --.. ._, ..-.,,...... .� ,.. ,.,w .... , .. ., . _...... _o_ -,':. _ . , . COMPONENT 5100 ft 100-499r ft2 500-999 ft2 . Z 1000 ft2 Insulation Ceiligg R-19 Package' Package Package - wall R-13 5 R-13 R-13 Package Floor Mandatory Package Package Package Fenestration U -Value 0.75 2 0.75 Package Package of CFA < 50 ftPkg + Removed4 Pkg + Removed Package Shading n/a Package Package Package Thermal Mass n/a Package Package Package Space Heating Mandatory56 Package PackagePackage & Cooling (No electric) (No electric) (No electric) •(No electric) Water Heating No Increase & No Change ,n/a n/a n/a n/a Replacement: No Increase Standard Standard Standard Standard Increase Allowed Allowed Allowed Allowed w/Calculation" w/Calculation w/Calculatio n w/Calculation 1. Meet the componen prescriptive requirement for Package D for slab -on -grade construction or Package E for raised floor construction (see Chapter 3) and all mandatory requirements. 2• "Heavy" and "Light Mass" mass walls may meet the Package D or E requirements for'rriass wall insulation instead of R-13 (see Chapter 3). . I I - 3. For compliance of additions and alterations only, dual glazed "greenhouse" windows and skylights may be assumed to meet this requirement. 4. The Package D or E fenestration area plus the area of any glazing removed because of the addition, 5. All.applicable mandatory measures for -insulation or HVAC systems must be met (see'.Chapter 2).------- - - 6. No electric•resistance space heating may be'installed: r:-- "- _ = " 7. A standard water heating system is explained in Section 6.6. - 8. If the total number of water heaters increases in the residence, then the entire existing plus addition system must meet the water heating energy budget (see Chapter 6). Table 3-4 lists water heating system combinations which have been pre -calculated to comply with the water heating budget. )fir Revised December 1992• . "Residential Manual-• 'Wh. .L:Y..�. .rl �.. "'w•S!+•.L.«.� _ ,...., 4i5ryyvtrfta+ #F�ltt .1,. 1 4`„ .�!'. � ,.,.a�.;, .a. _� 1�/ �( .;/.„y ^1 �( 4 r, x�1p t1LnU . . &tV3.'� 5!ub"J:5x '09+�l,jii+ �h�.><t� toy,�:t�,ta..da,.•x1.,2i),,M;!n... � Lai,;; r4i �7'...i:;lt '.2.--.J.�{J.'uy. .�.. iK,ti��adake5lk xa�,55 t�yiyat. a-�,sitrk�;Ja W.�.<'t. U.+ukwa-.. h{��R,'(� �-.}S�•'f{�Cfi�JL '::r ��N�lh.:'C .i� !� �.•.iu fl} �, F5 1 .1, a1. t - :I�i. U {� :r..r .... �. ,f - a NS:PW f,4�1, 44 �F". iv. 1 .. ...- _. ��'.Srtl4fjri"-, "f(5 35+�11'H,:: W+�^i•{� h..� . P� r�le}�,^_ -_.." f�5, �{w•�.. �•.. .. .1.• w1... +. .4 . . iY,.,r�. �.ti.1 - South Facing Glazing r -Component -,.. .. o 1 SHADING COEFFICIENT4 Table3-Zll: Prescriptive Packages for Climate Zone 11 South Facing Glazing r -Component -,.. .. o Package'. A. Package . B Package Ctt .... Package .,pA .� Package E BUILDING ENVELOPE 0.40 0.40 0.40 - 0.40 East Facing Glazing Insulation Minimums:,- - 0.40 0.40 0.40 North Facing Glazing .-^-.Ceiling., R-30 R-13 R-30 R-19 R-49 R-29 R-38;1 R-19" R-38 R-19 THERMAL MASSS "Heavy" Wallt. - (R-5.0) r. (R-5.5) N/A (R4.76j . (R-4.76) INFILTRATION CONTROL "Light Mass" Wall . ' Slab Floor Perimeter [R-6.0), R-7 [R-6.5] R-7 N/A R-7 N/A`wa NR" N/A NR 2 Continuous Barrier "--Raised Floor `„ �` R-13 R-19' R-30 R-193: ? R-19 Air -to -Air Heat Exchanger FENESTRATION NR NR NR NR .. SPACE HEATING.SYSTEM6 Maximum U -Value 0.65 0.65 0.40 0.65 - 0.65 Electric Resitance Allowed Maximum Total Area NR 14%' 16% 16% .` 16% " Maximum Total Nonsouth Facing Area 9.6% NR NR NR ' . NR If Heat Pump, Minimum South Facing Area 6.4% NR NR NR NR DOMESTIC WATER HEATING TYPE System must meet budget, Meets Meets Meets10 Meets + Meets see §151(b) and 151(f)(8) Budget Budget Budget Budget. Budget LEGEND: NR = Not Required; N/A =Not Applicable;_ REQ =Required See notes following Table 3-Z16. SHADING COEFFICIENT4 South Facing Glazing 0.40 0.40 0.66 0.66: 0.66 . West Facing Glazing 0.40 0.40 0.40 0.40 0.40 East Facing Glazing NR NR 0.40 0.40 0.40 North Facing Glazing NR NR 0.66 0.66 0.66 THERMAL MASSS REQ NR - REQ 20% 55 INFILTRATION CONTROL ` Continuous Barrier NR NR NR NR NR Air -to -Air Heat Exchanger NR NR NR NR NR .. SPACE HEATING.SYSTEM6 Electric Resitance Allowed NO NO YES7 NO NO ' . If Gas, AFUE= 78% 78% 78% 78% 78% If Heat Pump, Split System HSPFs = 6.8 6.8 6.8 6.8 6.8 Single Package System HSPF = 6.6 6.6 6.6 6.6 6.6 SPACE COOLING SYSTEM If Split System A/C, SEER =10.0 10.0 10.0 10.0 10.0 If Single Package A/C, SEERS = 9.7 9.7 9.7 9.7 9.7 DOMESTIC WATER HEATING TYPE System must meet budget, Meets Meets Meets10 Meets + Meets see §151(b) and 151(f)(8) Budget Budget Budget Budget. Budget LEGEND: NR = Not Required; N/A =Not Applicable;_ REQ =Required See notes following Table 3-Z16. Prescdptive Packages --- - Revised.J_anuary 1992-- -- _.._. ----- __ ___-• -_- .-. 3.31 .... _,. .. . .<Y�:_,. � ... _.:s d_..Y._ .. . � .. �tl::S..._..�x`.tJtSI".1'i:<r..:rl}.F+..�. _...t., i.':tt:a:c:s.1:•: _. zT r]. -a:..: cy:,y. .... �. .. - ..�_ �-.. .. -. JaY,� .__.i...]L tJ.4.c ___ bLw7ay.lLu -, i_. -_. ... - i41[SewuiJ Gii1s3�LiSlailiYt. ... �'9i.lilL`li.. i.Jn.i1N��-..:.L:1i.rth..s•sJ'�.•.v,+. [s..t--.i J'�.Ii-.1:1 La "V.s:.i...... �. . FA y -J OW T This set Of.plams and epecigcaWns MUST hm kept on the job &t ell ttnM and U is unlaced to xgamke &Ay 04 s. or alterstlow m 8&,ne without "ttan P6rmlesion Prom the Dap&rtment of Public Works, County of Butte. XCQX All Materials & Workmanship Shall Be In Ac"d"oe with Recognized Good Fraotio®s &.d In � D gg Prearvibed for the SpeciSed � an� N � Bl®atria�l Cod.® 31�, Plumbing 6? eoh& ie i U77E C OMY DEPARTMENT ELECSHALLTRICAL, MECHANICAL, C AL, AMD PLUMBINGC® �C�� �o�EED COMPY'�� CURRENT CHECKED) UM +� NEC, UMC MD Upc. ALL 9MOTURES AND EQUIPMENT IMCLUDIM0 OVERHAMM SHALL BE CLEAR OF ALL EASEMENTS. A SET BACK OF .5 FT. FROM THE SIDE AND f FT. FROM THE REAR PROPERTY LIMES AND 6. FT. FROM THE ROAD CENT LkP� ���g SE CLEAR OF STRUCTURES AM_C�J" F'OR A 2 FT. EAVE OVERHANG. 12 �5 = i Igor"� 7110-�%j o i ate' 30 60 01 ©Wb So 6p Provide /z" x 10" anchor bolts X16' O.C. max. and within 121, of ioini& /0 O T � BUTTE COUNTY BULOM DEPARTMENT aFIPDEED I ulao", 90 C11- Bal UBG Fe4- A�vo t,3c�q a*avca C)"Ij ys is II 4 OL c ---) 0 -,J Tk 17 rl A C,